The difficulty of having children, in cases where there is a clear desire to have them, is one of the most difficult situations a couple must face. Moreover, it is usual that going to an assisted reproduction centre entails high levels of emotional suffering, together with the appearance of feelings of anguish, loss and frustration.

For all these reasons and due to the complex relationships between psychological factors and fertility, the figure of the psychologist is necessary in assisted reproduction centres in order to offer psychological accompaniment during infertility treatments .

Objectives of psychological accompaniment in infertility treatments

Independently of the theoretical framework within which the accompaniment or the intervention is carried out, the final objective of this psychological accompaniment is to help the patient, or patients, to achieve a greater quality of life and mental health .

Regardless of the type of psychological support eventually offered to the patient, it is advisable that all patients attend the first visit with the clinician. And in the case of a couple’s treatment, they should come with these.

The goal of any psychological accompaniment is to ensure that patients understand the scope of their treatment options, receive sufficient emotional support and are able to cope with the consequences of the experience of an infertility treatment.

The techniques used within the therapeutic intervention focus on the following aspects:

  • Facilitate the expression of emotions.
  • Identify the cause of the emotional difficulty.
  • To educate the person or the couple about infertility , making sure they have enough information to make a decision about treatment.
  • Intervene to minimize the effects of stress and help patients manage coping strategies correctly.

Who is the target audience for psychological accompaniment

Recent studies indicate that between 25-65% of patients who come to infertility centers have several psychological symptoms that are significant, and these are mainly related to anxiety.

It is necessary to establish some correct guidelines that allow to detect those symptoms that denote the need for a psychological approach , and to classify which patients require the accompaniment of a professional in psychology during the treatment of infertility.

There are a number of factors that can predict a poor adjustment of patients to assisted reproduction treatment . Among these factors are the personal characteristics of the patient, his or her social situation and factors related to the treatment such as the side effects it may have on the person.

Most common problems and treatment

The most common conditions in the population with infertility problems include adaptive disorder, anxiety states, depressive moods , relationship problems, refusal to attend psychotherapy for infertility, and coping with outcomes or the end of treatment.

1. Adaptive disorder

This disorder is characterized by the appearance of emotional symptoms such as anxiety or depression, behavioral symptoms such as changes in behavior , or symptoms that arise in response to an external stressor such as loss of a job, economic problems, etc.

The symptoms manifest themselves as follows:

  • Discomfort in response to the stressor.
  • Significant impairment of social activity , family, work or academic activity.

Although this type of disorder generates a high degree of discomfort, it does not prevent the person from continuing with his or her daily routines. Usually it is the couple, social or family relationships that are most affected.

Psychological intervention in infertile patients will be carried out according to the symptoms they present. Difficulties in the couple’s relationship will also be addressed independently.

2. Anxiety states

Cognitive and behavioral techniques to manage anxiety and self-control are very useful both for patients who are in the process, and for later coping with stressful situations.

Other somatic or psycho-physiological alterations derived from states of anxiety such as eating disorders, sleep disorders or fatigue can also be treated by means of techniques to control physiological activation ; as well as through relaxation techniques.

The recommended types of intervention for this type of alteration are

  • Progressive muscle relaxation techniques .
  • Training in social skills and assertive behavior techniques.
  • Couples therapy.
  • Sex therapy .
  • Programming of rewarding activities.

3. Depressed mood

Depression seems to be the most frequent emotional problem that people suffer from when they are aware of their infertility, and after failed attempts at treatment. These problems tend to occur more in women than in men , who show a greater predisposition to present problems of repressed anxiety.

The first step is to normalize and legitimize the feelings and emotions that overwhelm the couple, making them understand that most people in their situation feel the same way.

Solution-focused therapy has been established as an affective therapy when working with the negative emotions associated with these processes, both on an individual and couple level.

4. Relationship problems

During the first contacts with the patients, it is necessary for the professional to assess the levels of communication and strategies for conflict resolution that the partners possess. Likewise, he/she must explore what type of defence mechanism each one is using to cope with the situation, and thus identify the dysfunctional aspects of these mechanisms.

Within the framework of the therapy, they will be taught to explain their pain and their needs, as well as to listen and address their partner’s concerns.

Communication within the couple may be affected during treatment. It is common for one’s feelings not to reach the other, keeping emotions to themselves with the possible intention of protecting the couple. However, this lack of communication can increase feelings of distress and guilt , and generate greater tension in the relationship.

5. Patients who refuse psychological intervention

Because of the high levels of stress, these people may refuse to see a psychologist or accept any kind of psychological help. Many of these patients do not recognize the need for therapy.

The role of the psychologist in these cases will be to make patients aware of the psychological effects that assisted reproduction therapies have on the person and the couple’s relationship.

6. Dealing with the results or the end of treatment

For some patients the failure of infertility treatments can mean an existential crisis with strong emotional reactions. These patients, especially those with sterility without cause, come to believe that their sterility has a psychological origin .

The psychologist must be aware that the affliction due to failed sterility treatment is difficult to overcome. And he or she should encourage patients to seek professional, family and social support.

Once the couple decides to end the reproductive treatments, they must build a new identity as childless couples . And to do so, it is convenient to re-evaluate the basis of their relationship. It is possible that in the face of this new situation certain issues that were not so important before may become relevant and generate new difficulties in the relationship.

As a solution you will need to discuss your priorities as a couple for the future, and remember the current reasons for continuing to function as a childless couple. One option is to see this new situation as a possibility for greater independence and privacy as a couple.